Individual
IAN GROOMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3551 W OLYMPIC BLVD, LOS ANGELES, CA 90019-3504
(323) 732-0350
Mailing address
3551 W OLYMPIC BLVD, LOS ANGELES, CA 90019-3504
(323) 732-0350
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1455
CA
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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